Gender-diverse care: Nursing

Transgender and gender-diverse individuals experience health disparities such as reduced access to healthcare and high rates of mental health disorders, violence, and substance abuse. These disparities can be traced to cultural stressors like stigma, harassment, and discrimination. As a nurse, you’ll provide patient-centered and gender-inclusive care for members of the transgender and gender-diverse community. 

Okay, first let’s focus on some terminology. Sex assigned at birth is classified as male or female and is based on one’s reproductive anatomy at the time of birth, and occasionally genetics. Of note, intersex refers to a person with sex traits, such as genetics, hormones, or reproductive anatomy, that don’t fit the typical classification of male or female sexes. Gender refers to socially constructed characteristics, such as appearance, behaviors, and roles, and how those characteristics are named and expressed by a person. On the other hand, a person’s gender identity is their inner awareness and naming of their gender, which may be the same as or different from their sex assigned at birth.  

So, when a person’s gender identity is the same as their sex assigned at birth, that person is cisgender. For example, a cisgender female is a person who identifies as female and whose sex assigned at birth is female. In contrast, a person who is transgender has a gender identity that is different from their sex assigned at birth. For example, a transgender male is a person who identifies as male and whose sex assigned at birth is female.  

Now, sometimes, a person can experience significant psychological distress when there’s a mismatch between their gender identity and their sex assigned at birth; this is called gender dysphoria. Finally, it’s important to note that some people may identify as non-binary or gender diverse (e.g. genderqueer, genderfluid, agender, two-spirit, etc), meaning their gender identity is not exclusively male or female.  

Okay, now let’s review what it means to transition. Transitioning is a process when a transgender person starts living in alignment with their gender identity instead of their sex assigned at birth. This process is unique for every person and may involve changing their name or pronouns, (which may be he/him, she/her, they/them, ze/hir, or even mixed pronouns like he/they). They also may begin altering their physical appearance; or medically transitioning through hormone or surgical interventions. Each person affirms their gender identity in a way that feels right for them, and they may choose to pursue all, some, or none of these interventions to support their gender transition.